Epidural Steroid Injections 101

What is an epidural steroid injection?
One of the treatments for back pain is to inject corticosteroids in the spine- in an area called the epidural space. Most of the nerves which transmit pain signals to the brain run in the spinal cord-so it makes sense to block the nerves here. The epidural space is the inner canal in the spinal cord and can only be accessed with a long thin needle.

Can anyone receive an epidural injection for back pain?

Definitely not. In some patients, the nerve may be pinched and irritated by pressure. When the nerve is pinched, it may cause pain, numbness or, tingling in the neck, arms, legs or buttocks. Sometimes the pain may also radiate down to the back of the foot. In most cases, individuals who have recent onset of back pain generally respond to epidural injections. Other individuals who have back pain which radiates to the back of the legs may be helped. For those individuals who have had back pain for many months or years, epidural injection will not help at all. Other individuals who have back pain from muscle pain, joint problems or arthritis generally do not respond to these injections.

How is the injection done?

The injection is done in an office setting and does not take more than 30 minutes. You will be asked to lie down flat on the table and bring your knees to your chest area. This opens up the epidural space. The physician will numb the skin with an anesthetic and then may use an x ray to guide the needle into the epidural space. An x ray is not always needed. Once the correct position is obtained, the corticosteroid is injected into the space.

Once the injection is done, you are monitored for 30 minutes and most patients can be discharged in 1-2 hours. The majority of individuals will feel numbness or a mild weakness in the arms or legs after the injections. Sometimes one may even feel dizzy. After an epidural injection, one cannot drive home.